Renal hypoperfusion: value of power Doppler imaging.

Clautice-Engle, T; Jeffrey, R. Brooke

doi:10.2214/ajr.168.5.9129416

Cited by 38 publications

(27 citation statements)

References 8 publications

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“…Overall, PD displays more signal than CD particularly at the renal poles and in the superficial cortex [5]. Failure of PD to produce the cortical blush in native kidneys may occur either selectively in the far renal cortex due to attenuation of the signal with depth, or diffusely as a result of obesity or inability of the patient to breathhold adequately [5,21].…”

Section: Renal Cortical Perfusionmentioning

confidence: 99%

“…In addition, PD may also help in differentiating normal variants such as the column of Bertin (color blush inside) from neoplasms (hypovascular), as well as in detecting small renal tumors in patients at risk [5,11]. Although contrast enhanced-CT is more accurate than PD for depicting sublobar perfusion defects, multifocal pyelonephritis, and tumors, and for distinguishing pyelonephritis from early renal abscess [21,22], PD should be regarded as a time-and cost-effective alternative to DMSA scintigraphy and contrast-enhanced CT [21]. Nevertheless, on the basis of PD alone, differentiating among the entities that produce focal areas of hypovascularity may be impossible, and the abnormalities seen are often nonspecific.…”

Section: Renal Cortical Perfusionmentioning

confidence: 99%

“…Another limitation of current PD technology is its inability to differentiate absolute absence of renal cortical flow, as occurs in global cortical ischemia or infarction, from other conditions that cause profound reduction in cortical blush by severe decrease and pruning of interlobular vasculature [20]. Suboptimal perfusion can be encountered in native kidneys with acute medical renal diseases (i. e., cortical necrosis and interstitial nephritis), as well as in malfunctioning renal allografts with acute tubular necrosis and rejection [20,21,24,25]. In renal transplants, cortical defects of PD signal correlate with impaired allograft function, but they do not always correspond to cortical areas that lack blood perfusion on gadolinium-enhanced MR [20].…”

Section: Renal Cortical Perfusionmentioning

confidence: 99%

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Power Doppler sonography: general principles, clinical applications, and future prospects

Martinoli¹,

Derchi²,

Rizzatto

et al. 1998

European Radiology

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Power Doppler sonography (PD) is a technique that displays the strength of the Doppler signal, rather than the flow velocity and directional information. Its increased flow sensitivity and better vascular delineation have been used to document the presence and characteristics of flow in vessels that are poorly imaged with conventional color Doppler (CD), to identify areas of ischemia, to demonstrate inflammatory hyperemia or increased and irregular flow in tumors, as well as to assess serial vascular changes related to interval therapy. The present review reports the general principles of PD, portrays the results of clinical studies available in the literature, and suggests future trends of development.

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Section: Renal Cortical Perfusionmentioning

confidence: 99%

Section: Renal Cortical Perfusionmentioning

confidence: 99%

Section: Renal Cortical Perfusionmentioning

confidence: 99%

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Power Doppler sonography: general principles, clinical applications, and future prospects

Martinoli¹,

Derchi²,

Rizzatto

et al. 1998

European Radiology

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“…Renal and perinephric abscesses may appear as fluid collections or as complex lesions with or without layers of debris or air. In children and young adults CD and PD analysis increase the sensitivity of US in detecting acute pyelonephritis up to 63% [38,39,40] by revealing single or multiple hypoperfused renal regions determined by inflammatory oedema (Fig. 9).…”

Section: Acute Renal Infectionsmentioning

confidence: 99%

Renal parenchymal diseases: Is characterization feasible with ultrasound?

Quaia

Bertolotto

2002

Eur Radiol

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Ultrasound (US) imaging of the kidneys has greatly improved in recent years with introduction of wideband transducers and advances is beamformer technology. US is often the first imaging technique to be employed in patients with renal failure, haematuria or proteinuria, after clinical and laboratory evaluation. After conventional US evaluation, Doppler US (DUS) and resistive indices (RIs) analysis provide renal functional evaluation. Anyway, both sensitivity and specificity of conventional US and DUS in renal parenchymal disease evaluation remains low. In the initial or mild clinical stages of renal parenchymal diseases, kidneys may present normal US morphological appearance and normal RIs values, whereas different renal parenchymal diseases may reveal similar appearance on US and DUS evaluation. Besides, different renal parenchymal diseases may present some distinct features on conventional US and DUS with colour Doppler (CD) and power Doppler (PD) evaluation, even though percutaneous renal biopsy is often necessary to reach definite diagnosis. Renal vasculitides and tubular-interstitial nephropathies are more frequently identified by conventional US and DUS than glomerular nephropathies, since glomerular component accounts only for 8% of the renal parenchyma, whereas the highest percentage is occupied by vascular and tubulo-interstitial component. Follow-up of acute renal failure, during and after medical treatment, is the most useful field of employment of conventional US and DUS techniques, since a progressive lowering of RIs is correlated to a progressive recovery of renal function.

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“…[1][2][3] To date, few reports have described the ability of PD to identify the collateral renal circulation. 4,5 The anatomic literature classically states that the renal capsule has an anastomotic collateral system between the renal artery and the neighboring vascular territories. Different anatomic classifications have been described.…”

mentioning

confidence: 99%